Heupler F A, Proudfit W L
Am J Cardiol. 1979 Oct 22;44(5):798-803. doi: 10.1016/0002-9149(79)90200-5.
Nifedipine was evaluated in the management of eight patients with intractable coronary arterial spasm. All had Prinzmetal's variant angina, normal or mildly abnormal coronary arteriograms, and a positive ergonovine maleate provocative test. Anginal attacks occurred at least three times a week in all patients during isosorbide dinitrate therapy. All patients had a decrease in frequency of ischemic attacks with nifedipine. Seven patients underwent repeat Holter monitor evaluation, which confirmed the absence of ischemic changes while they were taking nifedipine. When nifedipine dosage was decreased.or therapy discontinued in six patients, all experienced a recurrence of anginal attacks. Two patients had minor side effects, which required a decrease in the dose of nifedipine. Nifedipine was well tolerated, and no major complications occurred with its use. Nifedipine appears to be effective in the management of patients with symptomatic coronary arterial spasm and normal or mildly abnormal coronary arteriograms. Our data justify further investigation of nifedipine for treatment of such patients.
对硝苯地平在8例顽固性冠状动脉痉挛患者的治疗中进行了评估。所有患者均患有变异型心绞痛、冠状动脉造影正常或轻度异常，且马来酸麦角新碱激发试验呈阳性。在所有患者接受硝酸异山梨酯治疗期间，心绞痛发作每周至少3次。所有患者服用硝苯地平后缺血发作频率均降低。7例患者接受了动态心电图复查，证实服用硝苯地平期间无缺血性改变。当6例患者硝苯地平剂量减少或停药时，均出现心绞痛发作复发。2例患者出现轻微副作用，需要减少硝苯地平剂量。硝苯地平耐受性良好，使用过程中未发生重大并发症。硝苯地平似乎对有症状的冠状动脉痉挛且冠状动脉造影正常或轻度异常的患者有效。我们的数据证明有必要对硝苯地平治疗此类患者进行进一步研究。
